He aha nā Fibroids o ka ʻŌpū? Nā Hōʻailona, Nā Kumu, a me ka Lapaʻau

ʻO nā fibroids o ka ʻōpū nā ulu ʻaʻole ʻaʻai e ulu ana i loko a i ʻole a puni kou ʻōpū. He mau ʻōpū maʻamau kēia i hana ʻia i nā ʻiʻo a me nā pūnaewele, a hoʻopilikia lākou i kahi 80% o nā wāhine ma mua o 50 mau makahiki.

E noʻonoʻo i nā fibroids e like me nā ʻāpana maikaʻi ʻole e hiki ke loli nui i ka nui a me ka wahi. ʻOiai ke kani ʻino paha ka huaʻōlelo “ʻōpū,” ʻaʻole pinepine nā fibroids i ka maʻi kanesa, a nui nā wāhine e noho pū me lākou me ka ʻike ʻole ʻana aia lākou.

He aha nā fibroids o ka ʻōpū?

ʻO nā fibroids o ka ʻōpū nā ʻōpū o nā ʻiʻo palupalu e ulu mai ka paia o kou ʻōpū. Kāhea ʻia nō hoʻi lākou ʻo leiomyomas a i ʻole myomas e nā kauka, akā ʻo kēia mau huaʻōlelo a pau e wehewehe i ka mea hoʻokahi.

Hiki i kēia mau ulu ke liʻiliʻi e like me ka hua a i ʻole e nui e like me ka meliona. Loaʻa i kekahi mau wāhine hoʻokahi fibroid wale nō, ʻoiai he nui kekahi mau mea. ʻO ka ʻoiaʻiʻo maikaʻi, ʻo nā fibroids he benign, ʻo ia hoʻi ʻaʻole lākou e pālahalaha i nā ʻāpana ʻē aʻe o kou kino e like me ka maʻi kanesa.

Hiki i nā fibroids ke ulu i nā ʻāpana like ʻole o kou ʻōpū. Hiki iā lākou ke ulu i loko o ka paia o ka ʻōpū, ma ka ʻili waho, a i ʻole e kau mai ka ʻōpū ma kahi ʻano lāʻau.

He aha nā ʻano o nā fibroids o ka ʻōpū?

Hoʻokaʻawale nā kauka i nā fibroids ma muli o kahi e ulu ai lākou i loko o kou ʻōpū. Hoʻopili ka wahi i nā hōʻailona āu e ʻike ai a pehea lākou e mālama ʻia ai.

Eia nā ʻano nui āu e ʻike ai:

• Intramural fibroids: ulu kēia mau mea i loko o ka paia ʻiʻo o kou ʻōpū a ʻo ia ka ʻano maʻamau loa
• Subserosal fibroids: ulu kēia mau mea ma ka paia waho o kou ʻōpū a hiki ke ulu nui loa
• Submucosal fibroids: ulu kēia mau mea ma lalo pono o ka laina o kou ʻōpū a pinepine e hoʻoulu i ka kahe koko nui
• Pedunculated fibroids: kau kēia mau mea mai kou ʻōpū ma kahi lāʻau lahilahi a hiki ke wili, e hoʻoulu ana i ka ʻeha koke

Hiki i kēlā me kēia ʻano ke hoʻoulu i nā hōʻailona like ʻole, kahi e kōkua ai i kāu kauka e hoʻoholo i ke ala mālama maikaʻi loa no kou kūlana kūikawā.

He aha nā hōʻailona o nā fibroids o ka ʻōpū?

Nui nā wāhine me nā fibroids ʻaʻole ʻike i kekahi hōʻailona. Eia naʻe, i ka wā e loaʻa ai nā hōʻailona, pili pinepine lākou i ka nui a me ka wahi o nā fibroids.

E hele kākou i nā hōʻailona āu e ʻike ai, e hoʻomanaʻo ana ʻokoʻa kou ʻike mai ka ʻike o kekahi wahine ʻē aʻe:

• Kahe koko nui o ka malama: Hiki i kou mau manawa ke kaumaha loa a lōʻihi ma mua o ʻehiku mau lā
• Kaomi a i ʻole ka ʻeha o ka pelvis: Hiki iā ʻoe ke manaʻo i ka piha a i ʻole ka ʻeha i kou ʻōpū haʻahaʻa a i ʻole ka pelvis
• Ka mimi pinepine: Hiki i nā fibroids nui ke kaomi i kou ʻōpū mimi, e hoʻolilo ana iā ʻoe e pono e mimi pinepine
• Paʻakikī e hoʻopau i kou ʻōpū mimi: ʻIke paʻakikī kekahi mau wāhine e hoʻopau loa i ko lākou ʻōpū mimi
• Ka constipation: Hiki i nā fibroids e kaomi ana i kou rectum ke hoʻopaʻakikī i ka neʻe ʻana o ka ʻōpū
• ʻEha kua a i ʻole wāwae: Hiki i nā fibroids nui ke kaomi i nā aʻalolo, e hoʻoulu ana i ka ʻeha e pālahalaha ana i lalo i kou kua a i ʻole nā ​​wāwae

Hiki i nā hōʻailona liʻiliʻi ke komo pū me ka ʻeha i ka wā moe a i ʻole ka ʻōpū nui e hoʻolilo iā ʻoe e like me ka hāpai keiki. Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, pono ke kūkākūkā me kāu mea mālama ola.

He aha nā kumu o nā fibroids o ka ʻōpū?

ʻAʻole maopopo loa ke kumu pololei o nā fibroids o ka ʻōpū, akā manaʻo nā mea noiʻi he kuleana nui nā hormones a me nā genetics. Me he mea lā e hoʻoulu ana nā pae estrogen a me progesterone o kou kino i ka ulu ʻana o nā fibroids.

Nui nā mea e komo ana i ka hoʻomohala ʻana o nā fibroids:

• Nā loli hormonal: Hoʻoulu ka estrogen a me ka progesterone i ka ulu ʻana o nā fibroids, ʻo ia ke kumu e emi pinepine ai lākou ma hope o ka menopause
• Nā kumu genetic: Inā loaʻa i kou makuahine a i kou kaikuaʻana nā fibroids, ʻoi aku ka nui o kou loaʻa ʻana iā lākou
• Nā mea ulu: Hiki i nā mea e kōkua i kou kino e mālama i nā pūnaewele ke hoʻoulu pū i ka ulu ʻana o nā fibroids
• Extracellular matrix: ʻO kēia ka mea e hoʻopili ai nā cell, a hoʻonui ʻia i nā fibroids

Ke aʻo nei nā mea noiʻi i ke kumu e loaʻa ai i kekahi mau wāhine nā fibroids ʻoiai ʻaʻole loaʻa i nā mea ʻē aʻe. ʻO ka mea a mākou i ʻike ai, he mea maʻamau loa nā fibroids a ʻaʻohe mea āu i hana a i ʻole i hana ʻole ai i hoʻoulu ai iā lākou.

He aha nā pilikia o nā fibroids o ka ʻōpū?

ʻO kekahi mau mea e hoʻonui ai i kou manawa e loaʻa ai nā fibroids, ʻoiai ʻaʻole hōʻoia ka loaʻa ʻana o nā pilikia e loaʻa iā ʻoe lākou. Hiki i ka hoʻomaopopo ʻana i kēia mau mea ke kōkua iā ʻoe e noho ʻike pono e pili ana i kou olakino.

Eia nā pilikia nui i ʻike ʻia e nā mea mālama ola:

• Makahiki: ʻOi aku ka maʻamau o nā fibroids i kou mau makahiki hānau, ʻoi aku hoʻi i kou mau makahiki 30 a me 40
• Lāhui: ʻOi aku ka nui o nā wāhine ʻAmelika ʻApelika e loaʻa i nā fibroids a loaʻa pinepine iā lākou i nā makahiki ʻōpio
• Mōʻaukala ʻohana: Hoʻonui ka loaʻa ʻana o ka makuahine a i ʻole kahi kaikuaʻana me nā fibroids i kou pilikia
• Momona: Hiki i ka nui ke hoʻonui i kou pilikia, ma muli paha o nā pae estrogen kiʻekiʻe
• ʻAi: Hiki i ka ʻai ʻana i ka nui o ka ʻiʻo ʻulaʻula a me ka ham ke hoʻonui i ka pilikia, ʻoiai paha nā mea kanu ʻōmaʻomaʻo he palekana
• Malama mua: Hiki i ka hoʻomaka ʻana o kou manawa ma mua o 10 mau makahiki ke hoʻonui i kou pilikia

Hiki i kekahi mau mea ke hoʻemi i kou pilikia, me ka loaʻa ʻana o nā keiki, ka hoʻohana ʻana i nā papa hana hānau, a me ka ʻai ʻana i nā huahana waiū. E hoʻomanaʻo, he mau pilina helu wale kēia, a ʻokoʻa ka ʻike o kēlā me kēia wahine.

I ka wā hea e ʻike ai ʻoe i ke kauka no nā fibroids o ka ʻōpū?

Pono ʻoe e hoʻokaʻaʻike i kāu mea mālama ola inā ʻike ʻoe i nā hōʻailona e hoʻopilikia ana i kou ola i kēlā me kēia lā a i ʻole e hopohopo iā ʻoe. Mai kali i nā hōʻailona e lilo i mea koʻikoʻi ma mua o ka ʻimi ʻana i ke kōkua.

Eia nā kūlana kūikawā āu e hoʻonohonoho ai i kahi hālāwai:

• Kahe koko nui: Inā ʻoe e hoʻoinu ana i kahi pā a i ʻole tampon i kēlā me kēia hola no kekahi mau hola
• Nā manawa lōʻihi: Nā manawa malama e lōʻihi ana ma mua o ʻehiku mau lā
• ʻEha koʻikoʻi: ʻEha pelvis ʻaʻole e hoʻomaikaʻi me nā mea hoʻoemi ʻeha ma luna o ka counter
• Nā pilikia ʻōpū mimi: Ka mimi pinepine e hoʻopilikia ana i kou hiamoe a i ʻole nā ​​hana i kēlā me kēia lā
• Nā pilikia hānau: Inā pilikia ʻoe e hāpai keiki

E ʻimi i ka mālama ola koke inā ʻike ʻoe i ka ʻeha o ka pelvis koke a koʻikoʻi a i ʻole kahe koko nui e hoʻolilo iā ʻoe i nāwaliwali a i ʻole dizziness. Hiki i kēia ke hōʻailona o nā pilikia e pono ai ka mālama koke.

He aha nā pilikia hiki ke loaʻa i nā fibroids o ka ʻōpū?

ʻAʻole hoʻoulu ka hapa nui o nā fibroids i nā pilikia koʻikoʻi, akā he mea nui e ʻike i nā pilikia hiki ke loaʻa. Hiki i ka ʻike mua a me ka mālama ʻana ke pale aku i ka nui o nā pilikia mai ka lilo ʻana i mea koʻikoʻi.

Eia nā pilikia hiki ke loaʻa, ʻoiai he mea maʻamau ʻole lākou:

• Anemia: Hiki i ka kahe koko nui ke alakaʻi i ka nele hao, e hoʻoulu ana i ka luhi a me ka nāwaliwali
• Nā pilikia hānau: Hiki i kekahi mau fibroids ke hoʻopilikia i ka hoʻokomo ʻana a i ʻole ke kāohi i nā fallopian tubes
• Nā pilikia hāpai keiki: Hiki i nā fibroids ke hoʻonui i ka pilikia o ka miscarriage a i ʻole ka hānau mua
• Ka hoʻoino ʻana o nā fibroids: I ka wā e ulu nui ai nā fibroids ma mua o ko lākou lako koko, hiki iā lākou ke hoʻoulu i ka ʻeha koʻikoʻi
• Nā maʻi o ka ʻōpū mimi: Hiki i ka paʻakikī e hoʻopau loa i kou ʻōpū mimi ke alakaʻi i nā maʻi

ʻAʻole pinepine, hiki i kahi fibroid ke hoʻololi i ka maʻi kanesa, akā hana ʻia kēia i ka liʻiliʻi ma mua o 1% o nā hihia. E nānā kāu kauka i kou mau fibroids i ka wā o nā nānā maʻamau e hopu i nā loli mua.

Pehea e ʻike ʻia ai nā fibroids o ka ʻōpū?

E hoʻomaka kāu kauka me kahi nānā pelvis e nānā i nā mea kūpono ʻole i kou ʻōpū. Hiki iā lākou ke ʻike i nā wahi nui a i ʻole nā ​​ʻano kūpono ʻole e hōʻike ana aia nā fibroids.

Hiki i kekahi mau hoʻokolohua kiʻi ke hōʻoia i ka ʻike a hāʻawi i nā kikoʻī e pili ana i kou mau fibroids:

• Ultrasound: Hoʻohana kēia hoʻokolohua ʻeha ʻole i nā nalu kani e hana i nā kiʻi o kou ʻōpū
• MRI: Hāʻawi ka magnetic resonance imaging i nā kiʻi kikoʻī a kōkua i ka hoʻolālā ʻana i ka mālama
• Hysterosonography: Hoʻokomo ʻia ka wai maʻemaʻe i kou ʻōpū e loaʻa ai nā kiʻi ultrasound maopopo
• Hysteroscopy: Hoʻokomo ʻia kahi scope māmā lahilahi ma o kou cervix e nānā i loko o kou ʻōpū
• Laparoscopy: Hiki i kahi kamera liʻiliʻi i hoʻokomo ʻia ma o kahi ʻoki liʻiliʻi ke ʻike i nā fibroids ma waho o kou ʻōpū

Hiki i kāu kauka ke kauoha i nā hoʻokolohua koko e nānā i ka anemia inā ʻike ʻoe i kahe koko nui. Kōkua kēia mau hoʻokolohua e hana i kahi kiʻi piha o ke ʻano o ka hoʻopilikia ʻana o nā fibroids i kou olakino.

He aha ka mālama ʻana no nā fibroids o ka ʻōpū?

Pili ka mālama ʻana no nā fibroids i kou mau hōʻailona, ​​ka nui a me ka wahi o kou mau fibroids, a me kou mau hoʻolālā hāpai keiki i ka wā e hiki mai ana. Nui nā wāhine me nā fibroids liʻiliʻi, ʻaʻole hōʻailona, ​​ʻaʻole pono i kekahi mālama.

E ʻimi kākou i nā koho mālama āu e hāʻawi ai kāu kauka:

Nā lāʻau lapaʻau

• Ka mālama hānau hormonal: Hiki i nā papa, nā pā, a i ʻole nā ​​IUD ke kōkua i ka kaohi ʻana i ka kahe koko nui
• GnRH agonists: Hoʻemi kēia mau lāʻau lapaʻau i nā fibroids ma ka kāohi ʻana i ka hana hormone
• Tranexamic acid: Kōkua kēia lāʻau lapaʻau e hoʻemi i ka kahe koko nui o ka malama
• Nā mea hoʻohui hao: Kōkua kēia mau mea e mālama i ka anemia i hoʻoulu ʻia e ka kahe koko nui

Nā kaʻina hana ʻaʻole ʻoki

• Uterine artery embolization: Kāohi nā ʻāpana liʻiliʻi i ka kahe koko i nā fibroids, e hoʻemi ana iā lākou
• MRI-guided focused ultrasound: Hoʻopau nā nalu ultrasound kiʻekiʻe i ka pūnaewele fibroid

Nā koho ʻoki

• Myomectomy: Ka wehe ʻana i nā fibroids me ka mālama ʻana i kou ʻōpū
• Hysterectomy: Ka wehe ʻana i ka ʻōpū, kahi e hoʻopau mau ai i nā fibroids
• Endometrial ablation: Ka luku ʻana i ka laina o ka ʻōpū e hoʻemi i ka kahe koko nui

E hana pū kāu mea mālama ola me ʻoe e koho i ka mālama maikaʻi loa ma muli o kou kūlana pilikino a me nā makemake.

Pehea ʻoe e mālama ai i nā fibroids o ka ʻōpū ma ka home?

ʻOiai ʻaʻole hiki i nā lāʻau home ke hoʻōla i nā fibroids, hiki i kekahi mau loli nohona a me nā hana mālama ponoʻī ke kōkua iā ʻoe e mālama i nā hōʻailona a me ka ʻoluʻolu hou aku. Hana maikaʻi kēia mau ala me ka mālama lapaʻau.

Eia nā ala āu e kākoʻo ai i kou olakino ma ka home:

• Ka hoʻomehana: Hiki i kahi pā hoʻomehana a i ʻole ka ʻauʻau mahana ke kōkua i ka hoʻomaha ʻana i ka ʻeha o ka pelvis a me ka cramping
• Hoʻoikaika maʻamau: Hiki i ka hana kino ke kōkua i ka hoʻemi ʻana i ka ʻeha a me ka hoʻomaikaʻi ʻana i kou olakino holoʻokoʻa
• Mālama kaumaha: Hiki i nā hana hoʻomaha e like me ka yoga a i ʻole ka noʻonoʻo ke kōkua i ka mālama ʻana i ka ʻeha
• Nā loli ʻai: ʻAi hou aku i nā hua a me nā mea kanu ʻoiai e kaupalena ana i ka ʻiʻo ʻulaʻula he pono paha
• Nā meaʻai hao-waiwai: Hoʻokomo i nā meaʻai e like me ka spinach, nā pīni, a me nā ʻiʻo lahilahi e hakakā i ka anemia

Hiki i nā mea hoʻoemi ʻeha ma luna o ka counter e like me ka ibuprofen ke kōkua i ka ʻeha a hiki ke hoʻemi iki i ka kahe koko nui. Eia naʻe, e nīnau mau i kāu kauka ma mua o ka hoʻomaka ʻana i nā mea hoʻohui hou a i ʻole ka hana ʻana i nā loli ʻai nui.

Pehea ʻoe e hoʻomākaukau ai no kāu hālāwai kauka?

Hiki i ka hoʻomākaukau ʻana no kāu hālāwai ke kōkua iā ʻoe e hoʻohana nui i kou manawa me kāu mea mālama ola. Hōʻoia ka hoʻomākaukau maikaʻi e loaʻa iā ʻoe nā pane a pau i kāu mau nīnau a loaʻa iā ʻoe ka mālama maikaʻi loa.

Eia pehea e mākaukau ai no kāu kipa:

• E hahai i kou mau hōʻailona: E mālama i kahi moʻolelo o kou manawa malama, nā pae ʻeha, a me nā hōʻailona ʻē aʻe
• E papa inoa i kāu mau lāʻau lapaʻau: Hoʻokomo i nā lāʻau lapaʻau āpau, nā lāʻau lapaʻau ma luna o ka counter, a me nā mea hoʻohui
• E hoʻomākaukau i nā nīnau: E kākau i nā mea āpau āu e makemake ai e nīnau e pili ana i kou kūlana a me nā koho mālama
• E lawe mai i ke kākoʻo: E noʻonoʻo e lawe mai i kahi lālā ʻohana a i ʻole hoaaloha e hele pū me ʻoe i ka hālāwai
• E hōʻiliʻili i nā moʻolelo lapaʻau: E lawe mai i nā hopena hoʻokolohua a i ʻole nā ​​​​hoʻokolohua kiʻi e pili ana i kou mau fibroids

Mai kānalua e noi i kāu kauka e wehewehe i nā mea āu ʻaʻole i maopopo. Makemake kāu mea mālama ola e kōkua iā ʻoe e hana i nā hoʻoholo ʻike e pili ana i kou mālama.

Hiki ke pale ʻia nā fibroids o ka ʻōpū?

ʻAʻohe ala hōʻoia e pale aku ai i nā fibroids o ka ʻōpū ʻoiai ʻaʻole mākou i maopopo loa i ke kumu o lākou. Eia naʻe, hiki i kekahi mau koho nohona ke kōkua i ka hoʻemi ʻana i kou pilikia a i ʻole ka hoʻomāmā ʻana i ko lākou ulu ʻana.

Eia nā hoʻolālā e pono paha:

• E mālama i kahi kaumaha olakino: Hoʻopili ʻia ka momona i ka hoʻonui ʻana i ka pilikia fibroid
• E hoʻoikaika maʻamau: Hiki i ka hana kino ke kōkua i ka hoʻoponopono ʻana i nā hormones a me ka hoʻemi ʻana i ka pilikia
• ʻAi i kahi ʻai kaulike: E nānā i nā hua, nā mea kanu, a me nā huaola holoʻokoʻa ʻoiai e kaupalena ana i nā meaʻai i hana ʻia
• E kaupalena i ka waiʻona: Hiki i ka inu nui ʻana o ka waiʻona ke hoʻonui i ka pilikia fibroid
• E mālama i ke kaumaha: Hiki i ke kaumaha lōʻihi ke hoʻopilikia i nā pae hormone

E hoʻomanaʻo, hiki i nā wāhine e ola ana i nā ola olakino ke loaʻa i nā fibroids. Inā loaʻa iā ʻoe lākou, ʻaʻole ia ma muli o kāu hana hewa, a loaʻa nā mālama maikaʻi e kōkua iā ʻoe e ʻoluʻolu hou aku.

He aha ka lawe nui e pili ana i nā fibroids o ka ʻōpū?

He mea maʻamau loa nā fibroids o ka ʻōpū a hiki ke mālama ʻia. ʻOiai hiki iā lākou ke hoʻoulu i nā hōʻailona ʻoluʻolu ʻole, ʻaʻole pinepine lākou i ka weliweli a loaʻa nā koho mālama maikaʻi he nui.

ʻO ka mea nui loa e hoʻomanaʻo ai, ʻaʻole pono ʻoe e hoʻomanawanui wale. Inā hoʻopilikia nā fibroids i kou ola maikaʻi, hiki i kāu mea mālama ola ke kōkua iā ʻoe e loaʻa ka hoʻomaha.

ʻOkoʻa ka ʻike o kēlā me kēia wahine me nā fibroids, no laila ʻaʻole kūpono ka mea e hana ana no kekahi mea ʻē aʻe no ʻoe. E hana pili me kāu hui mālama ola e hoʻomohala i kahi hoʻolālā mālama e kūpono i kou mau hōʻailona, ​​nohona, a me nā pahuhopu.

Nā nīnau i nīnau pinepine ʻia e pili ana i nā fibroids o ka ʻōpū

Hoʻoulu mau anei nā fibroids o ka ʻōpū i nā hōʻailona?

ʻAʻole, nui nā wāhine me nā fibroids me ka ʻike ʻole ʻana. Hōʻike nā noiʻi a hiki i ka 75% o nā wāhine me nā fibroids ʻaʻole ʻike i kekahi hōʻailona. Pinepine ʻaʻole ʻike ʻia nā fibroids liʻiliʻi a hiki i ka wā e loaʻa ai lākou i nā nānā pelvic maʻamau a i ʻole nā ​​hoʻokolohua kiʻi no nā kumu ʻē aʻe.

Hiki i nā fibroids ke hoʻopilikia i koʻu hiki ke hāpai keiki?

ʻAʻole hoʻopili ka hapa nui o nā fibroids i ka hānau keiki, akā hiki i kekahi ke hoʻopaʻakikī i ka hāpai keiki a i ʻole ka hāpai ʻana i kahi hāpai keiki. ʻOi aku ka nui o nā fibroids e hoʻololi i ka ʻōpū o ka ʻōpū a i ʻole ke kāohi i nā fallopian tubes e hoʻoulu i nā pilikia hānau keiki. Inā ke ho'āʻo nei ʻoe e hāpai keiki, e kūkākūkā me kāu kauka e pili ana i kou mau fibroids.

E hele wale anei koʻu mau fibroids?

Pinepine e emi nā fibroids ma hope o ka menopause i ka wā e emi ai nā pae hormone. Eia naʻe, i kou mau makahiki hānau, ʻoi aku ka nui o ko lākou noho ʻana i ka nui like a i ʻole ka ulu ʻana i ka nui. Ke kū ʻole kekahi mau fibroids i ka ulu ʻana a i ʻole ke emi iki, akā ʻaʻole kēia kahi mea āu e hilinaʻi ai e hana.

ʻO ka ʻoki wale nō anei ka mālama ʻana no nā fibroids nui?

ʻAʻole pono. ʻOiai pinepine nā fibroids nui e pono ai ka mālama ikaika, hiki i nā koho ʻaʻole ʻoki e like me ka uterine artery embolization ke kūpono. E noʻonoʻo kāu kauka i ka nui, ka wahi, a me nā hōʻailona i hoʻoulu ʻia e kou mau fibroids i ka wā e hāʻawi ai i nā koho mālama.

Hiki i nā fibroids ke lilo i maʻi kanesa?

He mea maʻamau loa ka lilo ʻana o nā fibroids i maʻi kanesa. Emi iho ma mua o 1% o nā fibroids i ka hoʻololi ʻana i ka maʻi kanesa. ʻO ke ʻano o ka maʻi kanesa e hiki ke ulu, i kapa ʻia ʻo leiomyosarcoma, ulu pinepine ma ke kūʻokoʻa ma mua o nā fibroids i loaʻa. E nānā kāu kauka i kou mau fibroids i ka wā o nā nānā maʻamau e nānā i nā loli hopohopo.